Archives for November 2017

I’m trying not to cry. I had very expensive dental implants done because of extensive decay on my back teeth. I’m in for a check-up and asked my dentist why I had so much trouble with those teeth. He said it’s due to my need for braces. If my teeth would have been placed into proper alignment I likely wouldn’t have struggled with them. I asked him why he didn’t tell me this ahead of time. I couldn’t believe his answer. He said, “You never asked and I don’t do braces.” What?! Is it too late for me to get braces now that I already have dental implants? Will I have to remove them and start over?

Candace L.

Dear Candace,

I’m so sorry this was your experience with your dentist. Personally, I think it’s inexcusable. His job is to advise you on what you need for your teeth, not just what you ask about and what he supplies. You can likely still get the braces you need, but let’s discuss your options.

You could remove them, but that would be a difficult procedure for you. Then, to replace the teeth again with dental implants, you’ll need to build up the bone structure again with bone grafting. Then re-do the implant surgery.

My suggestion would be to leave them in and find an orthodontist who’s had experience working with implants. It wouldn’t hurt to have a dentist with significant expertise in dental implants consult with your dentist doing the braces.

Consider Invisalign with Your Dental Implants

Because most adults would not enjoy wearing traditional metal braces, I’m going to suggest Invisalign. These are clear aligners that no one will be able to see, even at a conversational distance. The treatment plan is also carefully developed by a sophisticated software program to give you the most effective treatment possible.

Your best solution would be to find a dentist with expertise in dental implants who also does the Invisalign procedure. Look at Dr. Murphrees’ bio page to get an idea of what type of training you’ll want your dentist to have to make this work. Your situation is more complicated than most. Truthfully, it wouldn’t hurt you to find a new dentist anyway. I’m not too keen on the one you currently have.

I feel absolutely humiliated. I’ve always had bad teeth even though I brush and floss regularly. No matter what I do I was always losing ground, and a fortune. Then I had three pregnancies which completely destroyed my teeth. I threw up the entire 9 months, which made things so much worse. I can’t afford to keep fixing these. I’m actually in debt because of my teeth. I’ve finally given up and went to the dentist to ask to extract them and give me dentures. He practically yelled at me and said I was being a complete idiot. That I will ruin my life getting dentures at 24. Are they really that bad or does he just want me to have to keep coming back?

Ariana G.

Dear Ariana,

I’m sorry he was so insensitive to you. Despite his horrific chairside manner, his advice to you was sound, especially given your age. There is a condition called facial collapse that is a direct result of dentures. Even worse, the longer you have them, the more severe the condition.

Here’s how it happens. Once you have your teeth extracted, your body begins reabsorbing the minerals in your jawbone to use elsewhere throughout your body. Unfortunately, that leads to your jaw shrinking. Wearing them for over a decade will lead to you not having enough jawbone to even keep your dentures in your mouth. At your young age, that will positively happen to you.

What Alternatives are There to Dentures?

The first thing I would do is try to save every tooth you can. Every tooth with natural tooth structure will save you money and agony later on. For those teeth which can’t be saved, your next best option is to get dental implants. Unlike dentures, these won’t cause you to lose jawbone. The prosthetic root placed in your jaw tells your body you still need the minerals.

Now, I do realize dental implants are expensive. So, get the ones you can afford, strategically placed to preserve the most jawbone. Then, get removable partial dentures placed elsewhere as you save up for the better solution.

My brother got a dental implant on one of his upper teeth. He absolutely loves it. He can eat and do anything he could when his tooth was healthy. I’m losing a tooth. I’d really like a dental implant. But, I’ve noticed that his gum above the dental implant looks a little gray. It doesn’t bother him. I, however, am a little more vain than he is. If I got an implant, would my gum be gray?

Laura I.

Dear Laura,

The issue your brother is facing with his gum has a few issues to it. First, thin gums. Second, a titanium implant. Finally, the placement of that implant. The first and third go together. An important consideration in properly placing dental implants is the thickness of the surrounding gum tissue. This is even more important when it’s a visible part of your mouth.

Getting those wrong can give two negative results. One is the visibility of the titanium implant, through the gums. The other is the recession of tissue over time, which will cause a dark color around the gum line.

However, if the gum tissue is extremely thin, your dentist can do everything right and the implant will still show. Fortunately, these days we have other options. You can get metal-free Zirconia or ceramic implants, both of which will not show up behind your gums the way their titanium counterparts do.

Who Should Do Your Dental Implants?

There are two aspects to dental implants that should be considered—form and function.
Form is referring to whether or not your dentist is an artistic cosmetic dentist. This is especially important with a visible front tooth. See what type of accomplishments they have with the AACD, you want them to either be accredited or have been recognized for their beautiful smiles.

Function is more of a technical issue. The implant procedure is rather complex. You don’t want a dentist who’s just going by what they’d learned in dental school. It’s not enough. Make sure they’ve done extensive post-graduate study at somewhere like LVI or the Dawson Academy.

One other thing to consider, though if you’re going to a qualified cosmetic dentist they’d be sure to go over this with you themselves, is whether or not you’ll want any other work done on your smile. Once the implant crown is made, there’s no way for it to be changed without making an entirely new crown. If you’re wanting to whiten your teeth, do it before the implant procedure is started.

I’m hoping something can be done to fix my smile, but I’m worried it’s too late. Plus, my dentist doesn’t even believe anything’s wrong with them. My dentist made porcelain veneers for me. I was very pleased with how they turned out. They’re the color and shape I wanted. So, everything should be perfect, right? That’s what my dentist says, but they look off-center to me. He swears it’s in my head, but I don’t feel like the line between my two front teeth is lined up where it should be. Can this be fixed? I don’t think it’s in my head and every time I smile it’s all I notice. This has ruined the whole thing for me.

Hannah D.

Dear Hannah,

There is a great deal of training that goes into both making porcelain veneers and creating a beautiful smile. Many dentists can’t even get the first part right. Then, you have to add in the second part. It’s not just about what goes into color and shape, but how things work together with the rest of your body. Your dentist seems to be getting the first part okay but not the second. I’m going to illustrate what I think has happened to you with a very famous smile—Tom Cruise.

Creating Beautiful Smiles With Porcelain Veneers

There’s a bit of geometry involved in smile design. In fact, symmetry is a very important factor. Look at Mr. Cruise’s picture on the right. You’ll notice the the line doesn’t go directly through the center of his front teeth. Even if his natural smile was asymmetrical, a good cosmetic dentist would have fixed that and made it symmetrical. Your dentist should have too.

The best cosmetic dentists are not satisfied if their patients aren’t. In fact, most of them have some form of a beautiful smile guarantee. It doesn’t sound like your dentist is on board with that type of thinking.

You may have to go to a dentist with more expertise in cosmetic procedures. You can always try to ask your dentist for a refund. After that, go to the mynewsmile.com website. They only recommend dentists who are highly skilled in cosmetic procedures. You’ll be able to get a gorgeous smile from them. If you’re worried, take a look at their smile gallery to see what type of results they’ve given past patients.